Search results for: stigma

Authors: Kumari Bandana Bhatt, Navin Bhatt

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Background: Orphans and vulnerable children (OVC) are high risk of physical, mental, sexual and emotional abuse and face social stigma and discrimination which significantly increase the risk of mental and behavioral disorders such as anxiety, depression or emotional problems even they stay in well run child care homes. The objective of this study was to estimate the prevalence of depression and determine the determinants among OVC in child care homes in Nepal. Methods: An institutional-based analytical cross-sectional study was conducted in twenty orphanages of five districts of Nepal. Six hundred two children were recruited into the study. After the informed consent form obtaining, the guardian and assent were interviewed by a semi-structured questionnaire and Beck Depression Inventory-II (BDI-II). Logistic regression was used for detecting the association between variables at the significant level of =0.05. Results: The study revealed that 33.20% of OVC had depression. Among them 66.80% of children experienced minimal depression, 17.40% had mild depression, 11.30% had moderate depression 4.50% had severe depression. Sex, alcohol drinking, congenital problem, social support and bully were the main variables associated with depression among OVC of the child care homes in Nepal. Conclusion: Prevalence of depression was high among the orphans and vulnerable children living in child care homes especially among the female children in Nepal. Therefore, early identification and instituting of preventive measures of depression are essential to reduce this problem in this special group of children living in child care homes.

Keywords: Mental health, Depression, Orphans and vulnerable children, child care homes

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Authors: Denis Nono, Catherine Abbo, Thomas Wenzel

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Introduction: The study explored socio-cultural perspectives of childhood disorders and its implications for health seeking. Emphasis was on exploring local understanding and perceptions and how these ideas affect health seeking. Study aim: To explore the socio-cultural perspectives of neuro-developmental disorders and its implications on health seeking behaviour. Methods: The methods used in this study included key informant interviews conducted with health professionals. Parents of the children aged (6-15 years) with neuro-developmental disorders were recruited from the hospital to participate in focus group discussion, participant observation and individual in-depth interviews. Results: The study found out that stigma extended from children to parents and caregivers who were also shunned by community members. Participants described their children as “a gift from God” others described them as “a test from God”. The communities perceive the disorders as a spiritual infliction and always insisted that the children be taken for Acholi cultural and traditional rituals to cleanse children and they believed that mental illness has spiritual linkages. Conclusion: This study gives unique insights into the perceptions of neuro-developmental disorders and health seeking behavior in Gulu District and neighboring communities. The results showed that communities linked disorders to spiritual affliction, misunderstandings between families, bewitching, and other supernatural forces. Some of the participants highly recommended biomedical approaches to prevention, management and control of the disorders.

Keywords: ethnography, health seeking, neuro-developmental disorders, socio-cultural

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Authors: Jabulani Gilford Kheswa

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This paper reports on the effects of unemployment on the sexual behaviour of male youth. Drawing from Jahoda’s deprivation theory, unemployed male youth is prone to psychological distress and as a result, they resort to drugs and alcohol abuse as a way to cope with discrimination. Studies showed that such youth is more inclined to be sexually aggressive and very often engage in criminal activities and risky sexual behaviour such as multiple sexual partners and unprotected sex to cover their feelings of emotional insecurities and negative self-concept. The purpose of the study was to investigate the impact of unemployment on the sexual behaviour of Xhosa- speaking male youth, aged 19-35, from Quzini Location, Eastern Cape, South Africa. A qualitative, explorative, descriptive and contextual design was followed using phenomenological method. The purposively sampled comprised fifteen unemployed males who gave their informed consent to be interviewed. For trustworthiness of the study, the researcher met the Lincoln and Guba’s principles, namely; credibility, dependability confirmability and transferability. The following themes were identified, namely; patriarchy, gender- based violence, drug abuse, stigma and discrimination, criminal activities, depression and low- self-esteem. Based on the findings, the recommendations are that the government and private sectors should create jobs aimed at reducing unemployment for unemployed youth and psycho-educational programmes that will equip them in the areas of sexual values and attitudes, communication and decision-making skills.

Keywords: discrimination, male-youth, sex, unemployment

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Authors: Olga Muries-Cantan, Alice Schippers, Climent Gine, Noelle van den Heuvel

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A systematic review of the literature about the quality of life perceptions of siblings of people with intellectual and developmental disabilities (ID/DD) has shown differences and similarities among siblings’ perceptions around the world. Some of these differences might be explained by the influence of cultural and religious backgrounds on siblings’ quality of life through values, beliefs, and perceptions of ‘normalcy’ and stigma. The main goal of the multiple case study that we present, is to explore the quality of life perceptions of two adolescent siblings of individuals with ID/DD in order to identify the role cultural influence has played in their perceptions of quality of life. Two siblings from different European regions will participate in the study: one from a Southern European country (Spain) and the other one from a Western European country (The Netherlands). Taking a cross-cultural perspective, concepts such as values, cultural beliefs regarding disability, expectations, identity, supports, desires, and sibling relationships, will be discussed in a semi-structured interview with each sibling. Data will be analysed following an interpretative phenomenological analysis (IPA). It is expected that findings will show the particularities of the experience of having a brother or a sister with ID/DD and the singular influence of the culture on siblings’ perceptions of quality of life. The results of this study will help to spread awareness around the necessity that researchers, practitioners, and policymakers take into account the cultural background of the individuals in order to provide them with better services and support. In this line, more culturally situated research is required to enlarge the knowledge in this field.

Keywords: culture, intellectual disability, quality of life, siblings

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Authors: Shenaz Ahmed, Hussain Jafri, Muhammed Faran, Wajeeha Naseer Ahmed, Yasmin Rashid, Yasmin Ehsan, Shabnam Bashir, Mushtaq Ahmed

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Low uptake of cascade screening for βeta-Thalassaemia Major (β-TM) in the ‘Punjab Thalassaemia Prevention Project’ (PTPP) in Pakistan led to the development of a ‘decision support intervention for relatives’ (DeSIRe). This paper presents the experiences of relatives of children with β-TM of the DeSIRe following its use by PTPP field officers in routine clinical practice. Fifty-four semi-structured qualitative interviews were conducted (April to June 2021) with relatives in seven cities in the Punjab province (Lahore, Sheikhupura, Nankana Sahab, Kasur, Gujranwala, Multan, and Faisalabad). Thematic analysis shows that participants were satisfied with the content of the DeSIRe and its delivery by the field officers in a family meeting. They understood the main purpose of the DeSIRe was to improve their knowledge of β-TM and its inheritance, to enable them to make decisions about thalassemia carrier testing, particularly before marriage. While participants raised concerns about the stigma of testing positive, they believed the DeSIRe was an appropriate intervention, which supported relatives to make informed decisions. Our findings show the DeSIRe is appropriate for use by healthcare professionals in routine practice in a low-middle income country and has the potential to facilitate shared decision-making about cascade screening for thalassemia. Further research is needed to prove the efficacy of the DeSIRe.

Keywords: thalassemia, Pakistan, cascade screening, decision support

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Authors: Jennifer McNeill

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Over the years UK Governments have extended the use of welfare conditionality to more marginalised groups. Whereas in the past, disabled people’s rights to unconditional welfare were defended, significant numbers of disabled people have in recent years been re-classified as ‘fit for work’ as a result of this policy shift towards increased conditionality targeting more welfare service user groups. This paper discusses findings from a five-year project exploring the ethics and efficacy of welfare conditionality. Drawing on repeat interviews over three years with 58 disabled welfare service users across England and Scotland, the paper explores the experience of, and impact of conditionality upon, disabled participants. In particular, participants described the process of claiming disability-related benefits as stigmatising, with some describing the medical assessments as demeaning, traumatic and even painful. The medical assessments are conducted by private contractors and participants felt they were treated unfairly, under suspicion and under surveillance. This finding is important in line with a recent UN report concerned with the practice of such assessments. The findings reveal that notions of ‘deservedness’ are embedded in this system as disabled recipients argue for their entitlement to welfare claims relative to what are deemed to be less deserving groups of benefit claimants. This indicates an increasing competition ethic within different sections of the most marginalised social groups that facilitate further forms of social fragmentation, particularly in relation to opposition to benefit cuts and other changes requiring concerted and organised forms of resistance. The impact of media and political scapegoating of the most marginal has generated divisions within even those who position themselves as legitimate recipients.

Keywords: disability, medical assessments, stigma, welfare conditionality

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Authors: Tracy Smith-Carrier

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In 1995, the World Health Organization declared that poverty was the biggest killer and the greatest cause of suffering in the world. Income is certainly a key social determinant of health, the lack of which causes innumerable health and mental health conditions. In seeking to provide relief from financial hardship for residents within their populace, states in the Global North have largely turned to the non-profit and charitable sector. The stigma and shame of accessing charity is a significant barrier for many, but what is more problematic is that the embrace of the charitable model has let governments off the hook from responding to their international human rights obligations. Although states are signatories to various human rights treaties and conventions internationally, many of these laws have not been implemented domestically. This presentation explores the limits of the charitable model in addressing poverty in countries of the Global North. Unlike in the ages passed, when poverty was thought to be an individual problem, we now know that poverty is largely systemic in nature. In this presentation, we will identify the structural determinants of poverty, outline why people are reticent to access charitable programs and services and how income security is reproduced through the charitable model, and discuss evidence-informed solutions, such as a basic income guarantee, to move beyond the charitable model in favour of a rights-based justice model. To move beyond charity, we must demand that governments recognize our fundamental human rights and address poverty and hunger using a justice model based on substantive human rights.

Keywords: basic income, charity, poverty, income security, hunger, food security, social justice, human rights

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Authors: Zelalem Markos Borko

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The quality of life of people with blindness is significantly influenced by the level of resilience they possess. A qualitative approach of the descriptive phenomenological design was employed to address basic study objectives. The researcher purposely selected three blind graduate students from Sidist Kilo Campus and conducted a semi-structured interview to gather data. Data were analyzed by using thematic coding techniques. The present study found that personal characteristics such as commitment, living hope, motivation, positive self-esteem, self-confidence, and communication have shaped resiliency for successful university students with visual disabilities. The finding showed that the school environment is the place in which blind students had developed/experienced social, psychological, and economical competency and hope for their academic and entire life success. Furthermore, the finding showed that blind students had experienced individual, family, school, and community-related risks in the success track. Therefore, governmental and non-governmental organizations should provide training for students with visual impairments that focus on the individual traits that shape resilience for academic success, such as commitment, living hope, motivation, positive self-esteem, self-confidence, and communication and also community-oriented training should be to break the social stigma and discriminations for the individuals with the visual impairment.

Keywords: blind students, risk and protective factors, lived experience, success

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Authors: Anissa Mary Thomas Thattil, Nancy Angeline Gnanaselvam, B. Ramakrishna Goud

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Faecal sludge management (FSM) is an unorganized sector, and in India, there is an absence of regulations regarding the collection, transport, treatment, and disposal of faecal sludge. FSM has a high degree of occupational hazards that need to be thoroughly understood in order to shape effective solutions. On-field observations of five FSM operations were conducted in Anekal Taluk of southern Karnataka. All five of the FSM operations were privately owned and snowball method of sampling was employed. Two types of FS operations observed were: mechanical emptying involving direct human contact with faecal sludge and mechanical emptying without direct human contact with faecal sludge. Each operation was manned by 3-4 faecal sludge operators (FSOs). None of the observed FSOs used personal protective equipment. According to the WHO semi-quantitative risk assessment, the very high risk occupational hazards identified were dermal contact with faecal sludge, inhalation of toxic gases, and social stigma. The high risk hazards identified were trips and falls, injuries, ergonomic hazards, substance abuse, and mental health problems. In all five FSM operations, the collected faecal sludge was discharged untreated onto abandoned land. FSM in India is fraught with occupational and environmental hazards which need to be urgently addressed. This includes formalizing the institution of FSM, contextualized behaviour change communication, capacity building of local bodies, awareness programmes among agriculturists and FSOs, and designation of sites for the safe harnessing of faecal sludge as soil nutrient.

Keywords: faecal sludge, faecal sludge management, FSM, occupational hazards, sanitation

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Authors: Timothy Mossman

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The number of adolescent children accompanying their immigrant parents to Canada has steadily increased since the 1990s. Much of the applied linguistics literature on these so-called ‘Generation 1.5’ youth has focused on their deficiencies as academic writers in US Rhetoric and Composition and ESL contexts in higher education and the stigma of ESL in US K-12 contexts. However, the literature on Generation 1.5 students and identity in Canadian higher education is limited. This qualitative study investigates the processes of identity construction of three Generation 1.5 students studying at a university in Metro Vancouver to find out what types of identities and representations of self and other they make relevant, the meanings they attribute to their identities, and what motivates them to construct these identities. The study analyzes the accounts and experiences of the participants in interviews, focus groups, and texts and as ‘culture-in-action,’ positing that they constructed identities as social categories associated with the languages and social practices of their countries of birth, in liminal spaces among a continuum between Canada and their countries of birth, and a spectrum of related cultural representations. Ideas and beliefs associated with broader ‘macro’ social structures in Canadian society related to language, culture, legitimacy, immigration, power, distinction, and racism were shown to be transcended in and through their representations of themselves and others. Data suggest that moving to Canada caused participants to experience discontinuities between their cultures, languages, and social practices, and in some cases a conflicting sense of self. The study brings implications for finding ways to understand the complexity of immigrant students, avoid reifying and generalizing about them, and not see them as stuck-in-between or lacking.

Keywords: culture-in-action, generation 1.5, identity, membership categorization analysis

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Authors: Lobna Ahmed Galal

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Modal integration has given minimal consideration in cities of developing countries, as well as the declining dominance of public transport, and predominance of informal transport, the modal share of informal taxis in greater Cairo has increased from 6% in 1987 to 37% in 2001 and this has since risen even higher, informal and non-motorized modes of transport acting as a gap filler by feeding other modes of transport, not by design or choice, but often by lack of accessible and affordable public transport. Yet non-motorized transport is peripheral, with minimal priority in urban planning and investments, lacking of strong polices to support non-motorized transport, for authorities development is associated with technology and motorized transport, and promotion of non-motorized transport may be considered corresponding to development, as well as social stigma against non-motorized transport, as it is seen a travel mode for the poor. Cairo as a city of a developing country, has poor quality infrastructure for non-motorized transport, suffering from absence of dedicated corridors, and when existing they are often encroached for commercial purposes, widening traffic lanes at the expense of sidewalks, absence of footpaths, or being overcrowded, poor lighting, making walking unsafe and yet, lack of financial supply to such facilities as it is often considered beyond city capabilities. This paper will deal with the objective measuring of the built environment relating to walking, in some neighborhoods of new cities around Cairo, In addition to comparing the results of the objective measures of the built environment with the level of self-reported survey. The first paper's objective is to show how the index ‘walkability of community neighborhoods’ works in the contexts in neighborhoods of new cities around Cairo. The procedure of objective measuring is of a high potential to be carried out by using GIS.

Keywords: assessing, built environment, Cairo, walkability

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Authors: Lauren McGillivray, Michelle Torok, Alison Calear

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Suicide is the leading cause of death for Australians aged 15-24 years, with rates increasing over the past decade. As young people can be particularly vulnerable to mental health problems and suicidal behavior, they are an essential and obvious target for suicide prevention efforts. This study investigates the effectiveness of the universal mental health promotion and suicide prevention program, Youth Aware of Mental Health (YAM), to reduce suicidal ideation and attempts and increase help-seeking in young people. This trial took place in Australian schools across four regions in New South Wales that form part of LifeSpan, a larger multilevel suicide prevention research trial. The YAM program was delivered to Year 9 students in up to 78 schools over two years (from January 2017 to December 2019). All schools were invited to participate in YAM's evaluation, which included completing a student questionnaire at three time-points: baseline, 3-month post-intervention, and 6-month follow-up. The primary outcome is suicidal ideation severity. Secondary outcomes are new reports of suicide attempts, stigma towards suicide, knowledge about suicide, help-seeking intentions and behaviors, and depressive symptoms. Results from pre-post and follow-up data will be presented. These research findings are promising and will contribute to the evidence-based for YAM and suicide prevention programs in Australian schools. These findings are also expected to promote YAM's value and sustainability to be more widely delivered in Australian secondary schools.

Keywords: adolescent mental health, suicidal ideation, suicide prevention, universal program

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Authors: Ellen Lagast, Melissa Ceuterick, Mark Leys

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Although adolescence is a stressful period with an increased risk for mental illnesses such as anxiety and depression, little in-depth knowledge is available on the determinants of the use of psychotropic drugs (BZD/SSRIs) and the effects. A qualitative research with adolescents in Flanders was performed. Based on indepth interviews, the interviewees indicate feelings of ambiguity towards their medication use because on the one hand the medication helps to manage their mental vulnerability and disrupted lives, but on the other hand they experience a loss of control of their self and their environment. Undesired side-effects and stigma led to a negative pharmaceutical self. The interviewed youngsters also express dissatisfaction about the prescription behavior with regard to psychotropic drugs of their general practitioner (GP). They wished to have received more information about alternative non-pharmaceutical treatment options. Notwithstanding these comments, the majority of the interviewees maintained trust in their GP to act in their best interest. This paper will relate the prescription behavior in primary care to the organization of mental health care to better understand the “phamaceuticalization” and medicalization of mental health problems in Belgium. Belgium implemented fundamental mental health care reforms to collaborate, to integrate care and to optimize continuity of care. Children and adolescents still are confronted with long waiting lists to access (non-medicalized) mental health services. This access to mental health care partly explains general practitioners’ prescription behavior of psychotropics. Moreover, multidisciplinary practices have not pervaded primary health care yet. Medicalization and pharmaceuticalization of mental health vulnerabilities of youth are both a structural and cultural problem.

Keywords: adolescents, antidepressants, benzodiazepines, mental health system, psychotropic drugs

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Authors: Medagedara Kaushalya Sewwandi Supun Gunarathne

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This research explores the underlying motivations and consequences of individuals changing their sexual orientation as a response to sexual violence. The primary objective of the study is to unravel the psychological, emotional, and social factors that drive individuals, akin to Celie in Alice Walker’s ‘The Color Purple’, to contemplate and undergo changes in their sexual orientation following the trauma of sexual violence. Through an analytical and qualitative approach, the study employs in-depth textual and thematic analyses to scrutinize the complex interplay between sexual orientation and violence within the selected text. Through a close examination of Celie’s journey and experiences, the study reveals that her decision to switch sexual orientation arises from a desire for a more favorable and benevolent relationship driven by the absence of safety and refuge in her previous relationships. By establishing this bond between sexual orientation and violence, the research underscores how sexual violence can lead individuals to opt for a change in their sexual orientation. The findings highlight Celie’s transformation as a means to seek solace and security, thus concluding that sexual violence can prompt individuals to alter their sexual orientation. The ensuing discussion explores the implications of these findings, encompassing psychological, emotional, and social consequences, as well as the societal and cultural factors influencing the perception of sexual orientation. Additionally, it sheds light on the challenges and stigma faced by those who undergo such transformations. By comprehending the complex relationship between sexual violence and the decision to change sexual orientation, as exemplified by Celie in ‘The Color Purple’, a deeper understanding of the experiences of survivors who seek a safe haven through altering their sexual orientation can be attained.

Keywords: sexual violence, sexual orientation, refuge, transition

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Authors: Afaf Alhusayni, Elizabeth Sheppard, Asiyya Jaffrani, Peter Mitchell, Lauren Marsh

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Introduction: Previous research has found that people make systematic judgments about others based on small glimpses of their behavior. Furthermore, autistic people are consistently judged more negatively than non-autistic people in terms of favourability and approachability. Objectives: This project focuses on a hitherto unstudied type of judgment that is highly relevant within a university context, judgments about academic performance. This is particularly important as autistic university students are less likely to complete their degrees than neurotypical students. Methods: Twenty-five neurotypical perceivers (21 females - 4 males) viewed a series of 4s video clips featuring an individual ‘target’ displaying natural behavior. Nine of these targets were autistic and nine were neurotypical. Perceivers were asked to rate each target on four aspects related to university life (motivation, success, grades, and happiness). Results: Autistic targets were judged more negatively on all aspects compared to neurotypical targets. Conclusions: This study concludes that neurotypical perceivers negatively judge the academic performance of autistic students. This suggests that autistic university students face unfavorable scrutiny and judgment, which may negatively impact their academic success. Implications: These initial findings provide important evidence that autistic people are negatively stigmatized within education environments. Further work is needed to ascertain the extent to which these negative judgments may feed into attainment gaps for autistic students. This information is useful for the education department, government, and social care organizations, enabling change in the provision of support for autistic students.

Keywords: autistic person perception, academic performance, stigma and judgment, higher education

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Authors: Kulveer Sandhu

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Background: In 1999, the Government of Canada legalized the use of cannabis for the therapeutic purpose (CTP); however, its users remain highly vulnerable to stigma and are judged by care providers and nonusers of cannabis. Findings from a literature review suggest health care providers (HCPs), including nurses in palliative care settings, lack knowledge about medical cannabis. For this reason, it is important to enhance HCPs’awarenessand knowledge of medical cannabis. Significance of the Project: Nurses are the first point of contact and spend more time with patients than other care providers; it is, therefore, important for them to be informed about CTPto provide quality and equitable care for medical cannabis users. Although nurses and other HCPs want information on CTP, the topic is rarely included in their educational curriculum. The purpose of this project is to create an evidence informed Package designed to increase knowledge among palliative care nurses about CTP. The information package will empower palliative nurses to help palliative patients make informed decisions about their treatment plan. Method: The information package will include a basic overview of the endocannabinoid system, common cannabis plants and products, and methods of consumption, as well as information to help nurses better understand consumption and harm reduction. The package will also include a set of cannabis fact sheets for nurses. Each fact sheet will comprise a high-level overview with graphics followed by a description of medical cannabis with links and references. At the end of the learning package, there are five self-reflection questions that allow nurses to examine their personal values, attitudes, and practices regarding medical cannabis. These questions will help each nurse understand their personal approach towards CTP and its users.

Keywords: medical cannabis, improve knowledge, cannabis for therapeutic purpose (CTP), patient experience, palliative care

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Authors: Priscilla Adoley Moffat

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One common element of African cultures is gender role socialization. This is a significant component of African cultures because gender roles are considered in these cultures, to define males and females and distinguish males from females. Various studies have established the impact of gender role socialization on individuals, on activities of individuals, including business activities, and on society, in general. This study further examined the effect of gender role socialization on the marketing of gendered products. The study sought to establish whether gender role socialization affects marketing, particularly word-of-mouth marketing, of gender-specific products. For a comprehensive examination of the influence of gender role socialization on word-of-mouth marketing of gendered products, 2150 respondents (1075 males and 1075 females), comprising 550 students of Marketing from various Ghanaian universities/colleges and 1600 other individuals (100 from each of the 16 regions of Ghana, representing the various cultures) were randomly sampled and interviewed. The study found that females are more willing to market male products than males when tasked to market female products. Also, females are more efficient in marketing male products than males in marketing female products. Again, most female audiences feel uncomfortable or embarrassed and are less receptive when approached by a male marketer of female products. Then, the study found that the fear of stigmatization is a major influencer of males’ negative attitude towards marketing of female products and that female marketers of male products, however, suffer less or no stigma. Aside from its addition to the literature on the impact of gender role socialization on marketing and, for that matter, the influence of socialization on marketing, the findings of the study are useful to multinational companies, which become better informed in their strategy when assigning marketing roles, especially in Africa.

Keywords: gender, socialization, marketing, gendered, role, Ghana

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Authors: Nisha James, Shubha Ranganathan

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One of the most poignant forms of organized crime against women, which has rarely made it to the world of Indian cinema, is that of sex trafficking, i.e. the forcible involvement of women in the sex trade through fraud or coercion (Hughes, 2005). In the space of Indian cinema, much of the spotlight has been on the sensational drug trafficking and gang mafia of Bombay. During our research on sex trafficking, the rehabilitated women interviewed often expressed strong criticism about mass media’s naive portrayal of prostitutes as money-minting, happy and sexually driven women. They argued that this unrealistic portrayal ignored the fact that this was not a reality for the majority of trafficked women. Given the gravity of sex trafficking as a human rights issue, it is, therefore, refreshing to see three recent films on sex trafficking in Indian Languages – Naa Bangaaru Talli (2014, Telugu), Mardaani (2014, Hindi) and Lakshmi (2014, Hindi). This paper reviews these three films to explore the portrayal of the everyday reality of trafficking for women. Film analysis was used to understand the representation of psychological issues in the media. The strength of these movies starts with their inspirations which are of true stories and that they are all aimed at bringing awareness about the issue of sex trafficking, which is a rising social evil in Indian society though none of the three films move to portray the next phase of rehabilitation and reintegration of victims, which is a very complex and important process in the life of a survivor. According to findings, survivors of sex trafficking find the rehabilitation and reintegration into society to be a slow and tough part of their life as they continuously face stigma and social exclusion and have to strive to live against all odds of non-acceptance starting from their family.

Keywords: film review, Indian films, sex trafficking, survivors

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Authors: Nesrine Boussaoui

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Background: International students often encounter challenges while studying in the UK, including communication and language barriers, lack of social networks, and socio-cultural differences that adversely impact on their mental health. For Algerian international students (AISs), these challenges may be heightened as English is not their first language and the culture of their homeland is substantially different from British culture, yet research has to incorporate their experiences and perspectives. Aim: The current study aimed to explore AISs’ 1) understandings of mental health; 2) issues of disclosure for mental health difficulties; and 3) mental health help-seeking and coping strategies. Method: In-depth, audio recorded semi-structured interviews (n = 20) with AISs in UK universities were conducted. An inductive, reflective thematic approach analysis was used. Finding: The following themes and associated sub-themes were developed: (1) Algerian cultural influences on mental health understanding(socio-cultural comparisons); (2) the paradox of the family (pressure vs. support); (3) stigma and fear of disclosure; (4) Barriers to formal help-seeking (informal disclosure as first step to seeking help); (5) Communication barriers (resort to mother tongue to disclose); (6) Self-reliance and religious coping. Conclusion: Recognising and understanding the challenges faced by AISs in terms of disclosure and mental health help-seeking is essential to reduce barriers to formal help-seeking. Informal disclosure among peers is often the first step to seeking help. Enhancing practitioners’ cultural competences and awareness of diverse understandings of mental health and the role of religious coping among AISs’ may have transferable benefits to a wider international student population.

Keywords: mental health, stegma, coping, disclosure

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Authors: Christine Maleesha Withanachchi, Eithne Heffernan, Derek Hoare

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Background: Social isolation (SI} is a major consequence of hearing loss (HL}. Isolation can lead to serious health problems (e.g., dementia and depression). Hearing Aids (HA) is the primary intervention for HL. However, these are less effective in social situations. Interventions are needed for SI in adults with hearing loss (AHL). Objectives: Investigated the relationship between HL and SI. Explored the views of AHL and hearing healthcare professionals (HHP) towards interventions for isolation. Methods: Individual and group semi-structured interviews were conducted. Interviews were conducted at the Nottingham Institute of Health Research (NIHR) Biomedical Research Centre (BRC). Six AHL and seven HHP were recruited via maximum variation sampling. The interview transcripts were analyzed using inductive thematic analysis. Results: Social impacts of HL: Most participants described that HL hurt them. This was in the form of social withdrawal, strain on relationships, and identity loss. Downstream effects of HL: Most audiologists acknowledged that isolation from HL could lead to depression. HL can also lead to exhaustion and unemployment. Impact of stigma: There are negative connotations around HL and HA (e.g. old age) and there is difficulty talking about isolation. The complexity of SI: There can be difficulty separating SI due to HL from SI due to other contributing factors (e.g. comorbidities). Potential intervention for isolation: Participants were unfamiliar with interventions for isolation and few, if any, were targeted for AHL specifically. Most participants thought an intervention should be patient-centered and run by an AHL in the community. Opinions differed regarding whether it should hear specific or generic. Implementation of intervention: Challenges to the implementation of an intervention for SI exist due to the sensitivity of the subject. Conclusions: This study demonstrated that SI is a major consequence of HL and uncovered novel findings related to its interventions. Uptake of interventions offered to AHL to reduce loneliness and social isolation is expected to be better if led by AHL in the community as opposed to HHP led interventions in the hospital or clinic settings.

Keywords: adults with hearing loss, hearing aids, interventions, social isolation

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Authors: Veliswa Nonfundo Hoho, Jabulani Gilford Kheswa

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HIV/AIDS has been a long-term condition worldwide, which does not only affect physical health but also causes psychological and social challenges in people living with this condition. In Sub-Saharan countries, namely; Nigeria, Uganda, Zimbabwe and South Africa, people living with HIV/AIDS come across different challenges especially after one has disclosed his/her status. They experience stigma and discrimination, isolation, lack of accessing and receiving treatment, lack of support and experience psychological distress. By using the evidence-based systematic review as a form of methodology, journal articles, dissertations, internet, and books were explored. This paper seeks to describe the challenges faced by people living with HIV/AIDS after disclosure, which forms a critical component of HIV/AIDS prevention and treatment interventions. The disclosure process model is used to underpin the study. This theory allows one to understand when and why interpersonal and verbal self-disclosure is beneficial for individuals who live with concealable stigmatized identities such as HIV/AIDS. Literature findings advocate that both negative and positive results were noted after disclosing one’s HIV status and psychosocial well-being of the majority of people living with HIV/AIDS also get affected especially in societies which subscribe HIV/AIDS pandemic to witchcraft. As for the infected homosexuals, research indicates that they suffer in silence and to cover their emotional emptiness due to ostracism, they often report low- self-efficacy with regard to condom use and become susceptible to reinfections which further place their lives at heightened risk for low immune system. In this regard, this paper challenges the policies which protect the dignity of people living with HIV/AIDS and calls for unity and financial support in favour of psychoeducational programmes and support groups aimed at curbing discrimination.

Keywords: disclosure, discrimination, homosexuality, self-efficacy

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Authors: Tom Ryan

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This paper investigates the rural mobility and accessibility challenges of a specific target group - Seniors. The target group is those over 66 years of age who are entitled to use the Public Transport (PT) Free Travel Scheme in rural Ireland. The paper explores at a high level some of the projected rural PT challenges and requirements over the next 10-15 years, noting that statistical predictions show that there will be a significant population demographic shift within the Senior's age profile. Using the PESTEL framework, the literature review explored existing research concerning mobility, accessibility challenges, and the opportunities Seniors face. Twenty-seven qualitative in-depth interviews with stakeholders within the ecosystem were undertaken. The stakeholders included: rural PT customers, Local-Link managers, NTA senior management, a Minister of State, and a European parliament policymaker. Tier 1 interviewee feedback spotlights that the PT network system does not exist for rural patients to access hospital facilities. There was no evidence from the Tier 2 research findings to show that health policymakers and transport planners are working to deliver a national solution to support patients getting access to hospital appointments. Several research interviewees discussed the theme of isolation and the perceived stigma of senior males utilising PT. The findings indicated that MaaS is potentially revolutionary in the PT arena. Finally, this paper suggests several short-, medium- and long-term recommendations based on the research findings. These recommendations are a potential springboard to ensure that rural PT is suitable for future Irish generations.

Keywords: accessibility, active ageing, car dependence, isolation, seniors health issues, behavioural changes, environmental challenges, internet of things, demand responsive, mobility as a service

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Authors: Niranjana Soperna, Shivangi Nigam

Abstract:

Violence against women is linked to their disadvantageous position in the society. It is rooted in unequal power relationships between men and women in society and is a global problem which is not limited to a specific group of women in society. An adolescent girl’s life is often accustomed to the likelihood of violence, and acts of violence exert additional power over girls because the stigma of violence often attaches more to a girl than to her doer. The experience of violence is distressing at the individual emotional and physical level. The field of research and programs for adolescent girls has traditionally focused on sexuality, reproductive health, and behavior, neglecting the broader social issues that underpin adolescent girls’ human rights, overall development, health, and well-being. This paper is an endeavor to address the understated or disguised form of violence which the adolescent girls experience within the social contexts. The parameters exposed under this research had been ignored to a large extent when it came to studying the dimension of violence under the social domain. Hence, the researchers attempted to explore this camouflaged form of violence and discovered some specific parameters such as: Diminished Self Worth and Esteem, Verbal Abuse, Menstruation Taboo and Social Rigidity, Negligence of Medical and Health Facilities and Complexion- A Prime Parameter for Judging Beauty. The study was conducted in the districts of Haryana where personal interviews were taken from both urban and rural adolescent girls (aged 13 to 19 years) based on structured interview schedule. The results revealed that the adolescent girls, both in urban as well as rural areas were quite affected with the above mentioned issues. In urban areas, however, due to the higher literacy rate, which resulted in more rational thinking, the magnitude was comparatively smaller, but the difference was still negligible.

Keywords: adolescent girls, education, social contexts, understated violence

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Authors: Gonzalo Ortiz de Elguea-Culebras, Raúl Sánchez-Vioquea, Adela Mena-Morales, Manuel Alaiz, Enrique Melero-Bravo, Esteban García-Romero, Javier Vioque, Lourdes Marchante-Cuevas, Julio Girón-Calle

Abstract:

Saffron (Crocus sativus L.) is a highly valued crop for the manufacture of spice that consists of the dried stigma of the flowers. This is in contrast to other underutilized parts of the saffron plant as leaves, which represent abundant biomass whose use might help to enhance the sustainability of the saffron crop. Saffron leaves contain significant amounts of phenolic compounds, 7.8 equivalent grams of gallic acid per 100g of extract, and are very promising compounds in terms of exploring novel uses of saffron leaves. Given that phenolic compounds have numerous effects on cancer-related biological pathways, we have investigated the in vitro antiproliferative effect of saffron leaf polyphenols against human colon adenocarcinoma cells (Caco-2). Polyphenols were extracted from leaves with 70% ethanol, defatted with hexane, and purified by solid phase extraction using C18 silica gel and then silica gel 60. Analysis of polyphenols was performed by HPLC-ESI-MS. Di-, tri-, and tetrahexosides of quercetin, kaempferol, and isorhamnetin, as well as C-hexosides like isoorientin and vitexin, were tentatively identified. Polyphenols strongly inhibited the proliferation of Caco-2 cells, which is consistent with model studies in which several of the polyphenols identified in saffron leaves have demonstrated their potential as chemopreventive agents in cancer. Due to the low profitability that saffron leaf currently represents, we consider these results very encouraging and that this by-product deserves further investigation as a potential source of active molecules against colorectal cancer.

Keywords: saffron leaves, agricultural by-products, polyphenols, antiproliferative effect, human colon adenocarcinoma cells

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Authors: Jessy Abouarab

Abstract:

For more than half a century, international norms related to refugee security and protection have proliferated, yet their role in alleviating war’s negative impacts on human life remains limited. The impact of refugee-security processes often manifests asymmetrically within populations. Many issues and people get silenced due to narrow security policies that focus either on abstract threat containment and refugee control or refugee protection and humanitarian aid. (In)security practices are gendered and experienced. Examining the case study of Syrian refugees in Lebanon, this study explores the gendered impact of refugee security mechanisms on local realities. A transnational feminist approach will be used to position this research in relation to existing studies in the field of security and the refugee-protection regime, highlighting the social, cultural, legal, and political barriers to gender equality in the areas of violence, rights, and social inclusion. Through Photovoice methodology, the Syrian refugees’ (in)securities in Lebanon were given visibility by enabling local volunteers to record and reflect their realities through pictures, at the same time voice the participants’ anxieties and recommendations to reach normative policy change. This Participatory Action Research approach helped participants observe the structural barriers and lack of culturally inclusive refugee services that hinder security, increase discrimination, stigma, and poverty. The findings have implications for a shift of the refugee protection mechanisms to a community-based approach in ways that extend beyond narrow security policies that hinder women empowerment and raise vulnerabilities such as gendered exploitation, abuse, and neglect.

Keywords: gender, (in)security, Lebanon, refugee, Syrian refugees, women

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: Vered Shenaar-Golan, Nava Wald, Uri Yatzkar

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Background: Parenting children with mental health problems poses multiple challenges, including coping with difficult behavior and negative child emotions. The impact on parents includes financial strain, negative social stigma, and negative feelings of guilt or blame, resulting in significant stress and lower levels of well-being. Given findings that self-compassion plays a significant role in reducing stress and improving well-being, the current study examined the role of self-compassion in the experience of parents raising a child with mental health problems. The study tested (1) whether child behavioral/emotional problem severity is associated with higher parental stress and lower parental well-being; (2) whether self-compassion is associated with lower parental stress and higher parental well-being; and (3) whether self-compassion is a stronger predictor of parental stress and well-being than child behavioral/emotional problem severity. Methods: Three hundred and six mothers and two hundred and fifty-six fathers of children attending a hospital child and adolescent psychiatric center were assessed at admission. Consenting parents completed four questionnaires: Child Strength and Difficulty – parent version, Self-compassion, Parent Feeling Inventory, and Well-Being. Results: Child behavioral/emotional problem severity was associated with higher parental stress and lower parental well-being, and self-compassion was a stronger predictor of parental stress and well-being levels than child behavioral/emotional problem severity. For children with internalizing but not externalizing behavioral/emotional problems, parental self-compassion was the only predictor of parental well-being beyond the severity of child behavioral/emotional problems. Conclusions: Cultivating self-compassion is important in reducing parental stress and increasing parental well-being, particularly with internalizing presentations, and should be considered when designing therapeutic interventions for parents.

Keywords: parenting children with mental health problems, self-compassion, parental stress, feelings, well-being

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Authors: Rebecca Haythorne

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Background: Agendas continuously emphasise the need to increase work based training and opportunities for individuals with learning disabilities. However research and statistics suggest that there is still significant stigma and stereotypes as to what they can contribute, or gain from being part of the working environment. Method: To tackles some of these prejudices an Occupational Therapy based intervention was developed for learning disability service users working at a social enterprise farm. The intervention aimed to increase positive public perception around individual capabilities and encourage individuals with learning disabilities to take ownership and be proud of their individual personhood and citizenship. This was achieved by using components of the Model of Human Occupation to tailor the intervention to individual values, skills and working contributions. The final project involved making creative wall art for public viewing, focusing on 'who works there and what they do'. This was accompanied by a visitor information guide, allowing individuals to tell visitors about themselves, the work they do and why it is meaningful to them. Outcomes: The intervention has helped to increased metal well-being and confidence of learning disability service users “people will know I work here now” and “I now have something to show my family about the work I do at the farm”. The intervention has also increased positive public perception and community awareness “you can really see the effort that’s gone into doing this” and “it’s a really visual experience to see people you don’t expect to see doing this type of work”. Resources left behind have further supported individuals to take ownership in creating more wall art to be sold at the farm shop. Conclusion: the intervention developed has helped to improve mental well-being of both service users and staff and improve community awareness. Due to this, the farm has decided to roll out the intervention to other areas of the social enterprise and is considering having more Occupational Therapy involvement in the future.

Keywords: citizenship, intervention, occupational therapy, personhood

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Authors: Tess Hartland, Moitree Banerjee, Sue Churchill, Antonina Pereira, Ian Tyndall, Ruth Lowry

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Background: Sexual health services and policies for middle-aged and older adults are underdeveloped, while global sexually transmitted infections in this age group are on the rise. The Interreg cross-Europe Sexual Health In Over 45s (SHIFT) project aims to increase participation in sexual health services and improve sexual health and wellbeing in people aged over 45, with an additional focus on disadvantaged groups. Methods: A two-pronged mixed-methodology is being used to develop a model for good service provision in sexual health for over 45s. (1) Following PRISMA-ScR guidelines, a scoping review is being conducted, using the databases PsychINFO, Web of Science, ERIC and PubMed. A key search strategy using terms around sexual health, good practice, over 45s and disadvantaged groups. The initial search for literature yielded 7914 results. (2) Surveys (n=1000) based on the Theory of Planned Behaviour are being administered across the UK, Belgium and Netherlands to explore current sexual health knowledge, awareness and attitudes. Expected results: It is expected that sexual health needs and potential gaps in service provision will be identified in order to inform good practice for sexual health services for the target population. Results of the scoping review are being analysed, while focus group and survey data is being gathered. Preliminary analysis of the survey data highlights barriers to access such as limited risk awareness and stigma. All data analysis will be completed by the time of the conference. Discussion: Findings will inform the development of a model to improve sexual health and wellbeing for among over 45s, a population which is often missed in sexual health policy improvement.

Keywords: adult health, disease prevention, health promotion, over 45s, sexual health

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Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

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Background: A myriad of physical, psychosocial, and environmental sequelae are associated with limb loss. However, there is a paucity of empirical South African data, which focuses on these sequelae, how they interface with the amputee’s quality of life as well as the challenges they experience following amputation. Objective: This study sought to explore the biopsychosocial effects of amputation and how amputation affected the quality of life of transtibial amputees. Setting: Participants were recruited from a medical facility, under the KwaZulu-Natal Department of Health in South Africa. Methods: A qualitative approach guided this study. Data was collected using one-on-one interviews with 14 unilateral transtibial amputees. Data was analysed thematically. Results: Five broad themes emerged from the inquiry, which captured amputees’ experiences of phantom limb pain, body image disturbances, and their challenges related to adapting to daily activities. Participants also expressed the salience of familial support as well as the importance of psychological interventions to cope. Conclusion: The findings suggested that support networks and professional psychological intervention are imperative in facilitating successful adjustment to the amputation experience. Raising awareness of limb loss in both, rural and urban settings may help reduce the stigma attached to it. Contribution: Quality of life comprises several domains, namely physical, psychological, environmental, and social albeit limited local and international data exists regarding the environmental and social effects. This study brought to the fore the positive and negative effects of amputation in each domain, as well as various strategies that facilitate successful adjustment to amputation.

Keywords: amputation, quality of life, biopsychosocial, phantom limb pain, body image, support

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